Best way to get air out of IV tubing for IV antibiotics is ? - page 2

by Blackcat99 | 10,674 Views | 15 Comments

Whats the best way to get rid of air? When I can hang an IV antibiotic with new tubing I can usually do OK with priming it and getting it ready. However, when I have to re-use IV tubing that has run dry on another shift it seems... Read More


  1. 2
    to the OP,
    one other small tip, for preventing air bubbles, in iv lines, is,
    when flooding the iv tubing, ensure you fill those lil compartments where the ports for secondary tubings to be attached are, with the fluid. Often, the tubing can be full, top to bottom, with fluid,
    but, those ports can harbor lil pockets of air, which will make your pump beep beep beep.

    Turning those ports upside down, when flooding the tubing, and flicking those lil air bubbles out, can help reduce the beepings.
    ~*Stargazer*~ and Blackcat99 like this.
  2. 2
    Quote from ~*Stargazer*~
    I thought NS flushes were a device, not a medication.
    I'll restate that, medications, and what isn't a medication, is defined by...

    Quote from ~*Stargazer*~
    If intermittent bags are overfilled with priming volume in mind, which is the case at my facility, then the patient will still receive the full dose.
    Medication bags are typically overfilled with volume, not medication, the amount that gets lost is highly variable, from none to 34cc, so overfilling with med still would mean they'd get the wrong dose much of the time.

    Quote from ~*Stargazer*~
    Also, while infusing 10mL from a pump might be an adequate flush for a PIV, it's not a substitute for pulsatile flushing, as is protocol for CVADs in my facility.
    I agree with you on pulsatile flushing, although I think we're the only two Nurses who practice that. Unfortunately, the 'powers that be' have discouraged the use of pulsatile flushing despite the manufacturers recommendations and the basic laws of fluid dynamics.

    Luckily, IV pumps are pulsatile, and while they aren't the same as a manual pulsatile flush, they're better than a manual non-pulsatile flush.

    Quote from ~*Stargazer*~
    Keeping the patient tethered to an IV pole interferes with mobility, and the risk of the patient unintentionally pulling out their IV is increased. To counteract these things, you disconnect the patient from the line when it's not in use, so you end up manipulating the connections the same amount anyway.
    This is true, although we looked at this and found that there were enough times where changing the set-up unnecessarily produced an additional tubing manipulation to justify an attempt to still limit the number of manipulations.

    Quote from ~*Stargazer*~
    Don't misinterpret me; I actually agree with you. I'm just playing a bit of Devil's Advocate here. I have bumped up against the policy that forbids hanging fluids when not ordered by the physician, because it makes no sense to me. It seems ridiculous that a practice that can increase RN efficiency and decrease infection risk is forbidden at my facility. The rationale I was given was that it was because of the risk of fluid overload in the event of incorrect pump programming, free flowing fluid, etc.
    As you've apparently noticed, those that write policies are sometimes surprisingly misinformed. I don't advocate just "going rogue", but bad policies should be challenged through the appropriate channels. We have a particularly "uppity" group of Nurses at my facility, so our process for fixing a bad policy is to write a position statement through our practice or research council that states how we will practice and why, and if the policy fails to keep up with good practice then we can't follow that, it works for us but other facilities are likely less tolerant of this.

    Quote from ~*Stargazer*~
    Whether it is a bad practice policy is debatable. Studies of PIV associated infection rates are slim. Evidence one way or the other is not conclusive, as far as I know. All we are left with is our opinion.
    The infection concern is more for central lines/PICCs, the dosing concern is related to all IVs.
    ~*Stargazer*~ and Blackcat99 like this.
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    This is such a great conversation... I have never heard of pulsatile flushing and had to google it!! My facility doesn't have a specific policy on priming, hanging NS flushes, pulsatile flushing, OR overfilling piggy backs for priming (pharmacy said it all depends on who did the mixing that day)...

    I'm hesitant to open such a huge can of worms by taking these issues further (like to our P&P dept), but technically I could be "punished" for doing something "wrong" like hanging a NS flush whether there's a specific policy or not, right??
    Blackcat99 likes this.
  4. 1
    Quote from helloberry
    This is such a great conversation... I have never heard of pulsatile flushing and had to google it!! My facility doesn't have a specific policy on priming, hanging NS flushes, pulsatile flushing, OR overfilling piggy backs for priming (pharmacy said it all depends on who did the mixing that day)...

    I'm hesitant to open such a huge can of worms by taking these issues further (like to our P&P dept), but technically I could be "punished" for doing something "wrong" like hanging a NS flush whether there's a specific policy or not, right??
    I wouldn't go against a specific policy (but if you think it's wrong then change it), but as Nurses we don't need a policy directive on everything we do, there are standards of care and best practices to refer to as well. Our facility is largely doing away with policies, instead referring to best practice sources, our goal is to only have policies that cover what isn't specified in best practice sources.

    Pulsatile flushing is a no-brainer if you consider basic fluid dynamics, but it's not very prevalent because the INS does not recommend, which is most likely due to Lynn Hadaway's opposition to it, even though her reasoning makes no sense and she clearly does not comprehend the purpose of it. Some manufacturers, such as Bard, specifically instruct that pulsatile flushing is to be used.
    Blackcat99 likes this.
  5. 2
    To get air out of an IV line (especially when it's causing the pump to beep):

    clamp the line near to the patient (below the access port you will be using) or disconnect the line from the patient's IV device

    open the pump/remove the line from the pump

    insert an empty 10cc syringe into a low port (but with a closed clamp between the patient and this port)

    draw some of the fluid through the line into your empty syringe, repeat as needed to draw all the air out of the line into your syringe

    put the line back into the pump, unclamp or reattach to the patient's IV, run IV fluids/meds as before

    voila!
    traumaerRN and Blackcat99 like this.
  6. 1
    You can actually take that a step further. You can tap the air bubbles out of the syringe (or even just tap them to the plunger side of the syringe) and simply put the fluids you drew out back into the line, depending upon how much fluid you pulled out to get the air out.

    I can do the whole step without disconnecting so it remains a closed system and just throw the syringe with air bubble away when I'm done.
    Blackcat99 likes this.


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